goiter - Hormone Health Network

Fact Sheet
Goiter
W h at i s a goi te r ?
A goiter is an enlarged thyroid gland. The thyroid gland, located
in the front of your neck, makes thyroid hormones. When your
thyroid gland is enlarged, it can produce too much, too little, or
just enough thyroid hormone.
What do thyroid hormones do?
Thyroid hormones travel from your thyroid gland through the
blood to all parts of your body. They control how your body
uses food for energy, and help all your organs work well. Thyroid
hormones affect your metabolism rate, which means how fast or
slow your brain, heart, muscles, liver, and other parts of your body
work.
What are the symptoms of
a goiter?
You can have a goiter but have no symptoms at all, other than
having some swelling at the base of your neck. Some people also
may have
• Tightness in the throat
• Coughing
• Hoarseness
• Trouble swallowing
• Trouble breathing
If your metabolism is too fast or too slow, you won’t feel well.
For example, if you don’t have enough thyroid hormone and your
metabolism slows down, you might feel tired and cold. Or, if you
have too much thyroid hormone, you might feel nervous and
warm.
Di d y o u kn o w?
The most common cause of goiter outside of
the U.S. is a lack of iodine in the diet. Iodine is
a substance in food (iodized salt and seafood)
that the thyroid uses to make thyroid hormones.
However, a lack of iodine is not common in the U.S.
because iodine is added to salt and many foods.
Thyroid
Gland
Definitions of thyroid conditions
Underactive thyroid gland: when the thyroid gland doesn’t
make enough thyroid hormone; also called hypothyroidism.
When the thyroid is underactive, the body’s metabolism runs
too slowly.
Overactive thyroid gland: when the thyroid gland makes
too much thyroid hormone; also called hyperthyroidism.
When the thyroid is overactive, metabolism runs too quickly.
Hashimoto’s disease (the most common cause of
underactive thyroid): when the immune system attacks and
damages the thyroid gland; then the damaged gland no
longer makes enough thyroid hormone.
Graves’ disease (the most common cause of overactive
thyroid): when the immune system attacks the thyroid gland
and causes it to make too much thyroid hormone.
What causes a goiter?
In the U.S., the most common causes of swelling are
• Hashimoto’s disease (leading to an underactive thyroid)
• Graves’ disease (leading to an overactive thyroid)
• Nodules (lumps) on one or both sides of the thyroid gland
Less common causes include a hormone made during pregnancy
that increases thyroid hormone production, inflammation of the
thyroid, or thyroid cancer. A goiter also can be present in a newborn
if his or her thyroid gland doesn’t work properly before birth.
find the cause of the goiter and to see how advanced it is, such as
• Hormone tests to show whether your thyroid gland is
underactive or overactive
• Antibody tests for Hashimoto’s disease and Graves’ disease
• Ultrasound to see the size of your thyroid and whether there
are nodules
• A thyroid scan to look at your thyroid, especially if your thyroid
is overactive
• Other scans (CT or MRI) of the neck to check your windpipe
• A biopsy (using a needle to get a sample of your thyroid for
testing)
What is the treatment for a goiter?
Treatment depends on the cause of the goiter, its size, and your
symptoms. If your goiter is small and your thyroid is making
normal amounts of thyroid hormone, your doctor might observe
the goiter over time instead of starting treatment right away.
Possible treatments include
• Medicines for underactive or overactive thyroid
• Radioactive iodine for overactive thyroid (to shrink the goiter)
Surgery is rarely used. However, removal of the thyroid gland might
be recommended for a large goiter, for one causing breathing or
swallowing problems, for nodules, or for thyroid cancer.
Questions to ask your doctor
• What is causing my goiter?
• What are my options for treatment?
What factors increase the risk
of a goiter?
• What are the risks and benefits of each
treatment option?
Risk factors include
• Being a woman
• Being over age 40
• Being pregnant or in menopause
• Having a family history of autoimmune disease or goiter
• Having been exposed to radiation as a child or having had
radiation treatment to your neck or chest
• Having a diet low in iodine
• How long will I need treatment?
Some medicines also increase the risk of goiter.
How is a goiter diagnosed?
A goiter is often found during a physical exam when your doctor
feels swelling in your neck. Your doctor also may use other tests to
Editors
Bryan Haugen, MD
James Hennessey, MD
Leonard Wartofsky, MD
January 2013
• Should I see an endocrinologist for my care?
Resources
• Find-an-Endocrinologist: www.hormone.org
or call 1-800-HORMONE (1-800-467-6663)
• Hormone Health Network information about thyroid disorders:
www.hormone.org/Thyroid/overview.cfm
• Mayo Clinic information about goiter: www.mayoclinic.com/
health/goiter/DS00217
• MedlinePlus (National Institutes of Health) information about
goiter: www.nlm.nih.gov/medlineplus/ency/article/001178.htm
The Hormone Health Network offers free, online resources based
on the most advanced clinical and scientific knowledge from
The Endocrine Society (www.endo-society.org). The Network’s goal
is to move patients from educated to engaged, from informed to
active partners in their health care. This fact sheet is also available
in Spanish at www.hormone.org/Spanish.
Goiter Fact Sheet
www.hormone.org